Bowed legs is a bony deformity resulting in the outward curvature of one or both knees of the lower legs. It is commonly seen in toddlers and overweight adolescents.
Children under 2 years of age may present with bowed legs (physiologic), which usually corrects itself by the age of 3 to 4 years. Bowed legs may be associated with Blount’s disease (an abnormality of growth plates present at the ends of long bones) and rickets (bone disease due to deficiency of vitamin D, calcium and phosphorus).
It is more noticeable while standing and walking with the feet together, where an obvious space is noticed between the knees. In toddlers with bowed legs, the development of walking is not delayed and coordination is normal, but gait is awkward. Bowed legs are usually painless, but may cause ankle, hip and knee discomfort by adolescence due to the pressure applied on these joints. It may be associated with intoeing (inward curvature of the forefoot) and frequent tripping.
When your child presents with the above symptoms, your child’s doctor will perform a thorough physical examination. Symmetric bowing before the age of 2 years does not require further testing. If bowing is more prominent in one leg or your child is older than 2-1/2 years, your doctor will order an X-ray and blood tests to identify Blount’s disease or rickets.
Physiologic bowed legs do not require treatment, but your doctor may want to examine your child every 6 months to follow its progress. Early Blount’s disease may be treated with braces. Medication and orthopedic treatment are necessary to control rickets. Surgery is recommended to correct persistent bowed legs resistant to conservative management. It involves altering the growth plates or cutting and realigning the shinbone near the knee to correct the alignment. Following surgery, physical therapy is usually recommended to improve strength and range of motion.